BMC Cardiovascular Disorders最新文献

{"title":"Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention.","authors":"Can Zhou, Minghui Zhang, Zixu Zhao, Enze Li, Yichen Zhao, Hong Wang, Wei Luo, Keyang Zheng, Yu Liu, Chengqian Yin, Xinyong Zhang, Hai Gao, Xiaotong Hou, Dong Zhao, Changsheng Ma","doi":"10.1186/s12872-025-04639-2","DOIUrl":"https://doi.org/10.1186/s12872-025-04639-2","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiogenic shock (CS) is a lethal complication of ST-elevation myocardial infarction (STEMI). The impact of post-procedure anticoagulants (PPAC) in STEMI-CS patients undergoing primary percutaneous coronary intervention (PPCI) remains unknown.</p><p><strong>Method: </strong>In the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome registry (2014-2019), STEMI patients with CS on admission undergoing PPCI were stratified into two groups based on the use of PPAC or not. The primary outcome was all-cause mortality during hospitalization. Other outcomes including major bleeding were also investigated.</p><p><strong>Results: </strong>Of 36,873 patients with STEMI, 855 eligible patients with CS undergoing PPCI were included in our study, among which 614 patients were treated by PPAC and 241 were not. Adjusted by multi-variable Cox regression, PPAC was associated with a lower risk of in-hospital all-cause mortality (14.9% vs. 30.3%; adjusted HR: 0.60; 95% CI: 0.37 to 0.97; p = 0.037), while a non-significant difference in major bleeding (4.6% vs. 7.0%; adjusted HR: 1.05; 95% CI: 0.36 to 3.05; p = 0.925) was observed between PPAC and non-PPAC. Consistent results were observed in the sensitivity analyses adjusted by propensity score matching and inverse probability of treatment weighting.</p><p><strong>Conclusion: </strong>Our study suggested the use of PPAC in STEMI-CS patients undergoing PPCI was associated with a lower risk of in-hospital all-cause mortality without increasing the risk of major bleeding.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT02306616. Registered 29 November 2014.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"231"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative hemodynamic imbalance quantification: clinical validation of heart rate to mean blood pressure ratio in predicting myocardial injury after noncardiac surgery.","authors":"Yuanjun Zhou, Weiming Chen, Fei Liang, Liping Zhong, Yilin Liao, Yuting Zhong","doi":"10.1186/s12872-025-04650-7","DOIUrl":"https://doi.org/10.1186/s12872-025-04650-7","url":null,"abstract":"<p><strong>Background: </strong>The effects of isolated heart rate (HR) and mean blood pressure (MBP) on myocardial injury after noncardiac surgery (MINS) have been investigated, but the combined impact of intraoperative HR and MBP remains unclear. This study aimed to assess the influence of the heart rate-mean arterial pressure ratio (HMR) on MINS to optimize hemodynamic management.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients who underwent general anesthesia and postoperative troponin measurements at Meizhou People's Hospital. The primary exposure was the time-weighted area above the HMR threshold (1.0) (TWAAT-HMR > 1.0), and the primary outcome was MINS within one postoperative day. The diagnostic performance of TWAAT-HMR > 1.0, the time-weighted area under MBP < 60 mmHg, and the time-weighted area above HR > 100 bpm was evaluated using Receiver Operating Characteristic (ROC) analysis. Logistic regression and restricted cubic splines (RCS) were used to assess the association between HMR and MINS. Sensitivity analyses were conducted to confirm the robustness of the findings, and subgroup analyses examined potential interactions with age, sex, and body mass index.</p><p><strong>Results: </strong>Among 699 patients, the incidence of MINS was 9.4%. TWAAT-HMR > 1.0 demonstrated superior predictive accuracy for MINS compared to time-weighted areas under/above MBP and HR (AUC: 0.708 vs. 0.646 and 0.640, respectively). TWAAT-HMR > 1.0 was identified as an independent risk factor for MINS (odds ratio [OR] = 1.71, 95% confidence interval [CI] 1.35-2.17, p < 0.001). RCS analysis showed a linear increase in MINS risk with rising HMR (p for non-linearity = 0.507). Sensitivity and subgroup analyses supported the primary findings.</p><p><strong>Conclusion: </strong>Elevated HMR is associated with a higher risk of MINS in adults undergoing general anesthesia. HMR monitoring may serve as a valuable parameter for optimizing perioperative hemodynamic management.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"229"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective cohort study on the intraoperative monitoring of right ventricular function in tumors involving the inferior Vena Cava.","authors":"Fei Huo, Ran Zhang, Ting Hai, Hui Ju, Yan Jiang, Yi Feng, Luyang Jiang","doi":"10.1186/s12872-025-04637-4","DOIUrl":"https://doi.org/10.1186/s12872-025-04637-4","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate right ventricular function during surgery for tumor thrombus in the inferior vena cava (IVC) and/or right atrium (RA) using intraoperative transesophageal echocardiography (TEE). It also sought to provide evidence supporting the monitoring and hemodynamic management of the right heart by examining the relationship between the use of vasoactive drugs and changes in right ventricular function in patients with RA invasion versus those with thrombus limited to the IVC after tumor resection.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent IVC tumor resection at Peking University People's Hospital between June 201 3and October 2021. The collected data included patient demographics, right ventricular function parameters (measured by intraoperative TEE), perioperative use of vasoactive drugs, and postoperative hemodynamics. Patients were categorized into two groups: RA (tumor invading the right atrium) and IVC (tumor confined to the IVC).</p><p><strong>Results: </strong>The study included 15 patients, 11 of whom (73.3%) had RA invasion. Both fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) showed significant improvement postoperatively. The postoperative right ventricular end-diastolic volume (RVEDV) was larger in the RA group, who also experienced longer hospital stays.</p><p><strong>Conclusions: </strong>Postoperative right ventricular systolic function improved in patients with IVC thrombus. However, RA invasion was associated with longer recovery times, underscoring the need for targeted management to prevent right ventricular failure, particularly following relief of IVC obstruction.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"230"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and validation of a predictive model for intracardiac thrombus risk in patients with dilated cardiomyopathy: a retrospective study.","authors":"Xuetao Zhu, Jun Li, Yi Jiang, Tianqi Wang, Zeping Hu","doi":"10.1186/s12872-025-04581-3","DOIUrl":"10.1186/s12872-025-04581-3","url":null,"abstract":"<p><strong>Background: </strong>Systemic embolic events due to exfoliation of intracardiac thrombus (ICT) are one of the catastrophic complications of dilated cardiomyopathy (DCM). This study intended to develop a prediction model to predict the risk of ICT in patients with DCM.</p><p><strong>Methods: </strong>Data from 632 patients with DCM from a hospital was collected. ICT was identified based on the results of transthoracic echocardiography. Basic information, vital signs, comorbidities, and biochemical data were measured and collected from each patient. The least absolute shrinkage and selection operator (LASSO) regression was used for the final model variable screening. Four classifiers including Logistic Regression, support vector machine (SVM), Random Forest, and eXtreme Gradient Boosting (XGBoost) were used for model construction respectively. The area under of the curve (AUC) with 95% confidence interval (CI), sensitivity, specificity, and accuracy of the models were calculated to assess the predictive ability of the models.</p><p><strong>Results: </strong>Of these 632 DCM patients, 88 (13.92%) had ICT and 544 (86.08%) did not. Eleven clinical variables were selected for the construction of predictive models. The AUC of the Logistic Regression model to predict ICT probability was 0.854 (95%CI: 0.811-0.896), the SVM model was 0.769 (95%CI: 0.715-0.824), the Random Forest model was 0.917 (95%CI: 0.887-0.947), and the XGBoost model was 0.947 (95%CI: 0.924-0.969). The Delong test demonstrated that the XGBoost model had the highest AUC for predicting the ICT probability compared to other models (P < 0.05). Moreover, D-dimer, age, and atrial fibrillation contributed the most to the XGBoost model among these 11 variables.</p><p><strong>Conclusion: </strong>The XGBoost model has a good predictive ability in predicting ICT risk in patients with DCM and may assist clinicians in identifying ICT risk.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"224"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyridostigmine-induced complete atrioventricular block in a patient with Musk antibody-negative myasthenia gravis a case report : Pyridostigmine-ind advanced AV block in MG patient with MuSK-neg.","authors":"Mohammad Taghi Hedayati Godarzi, Mohamad Rashid, Saeed Abrotan, Marjan Fallah, Mehdi Seifi, Novin Nikbakhsh","doi":"10.1186/s12872-025-04681-0","DOIUrl":"10.1186/s12872-025-04681-0","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis (MG) is a rare autoimmune neuromuscular disorder in which autoantibodies impair neuromuscular junctions. MG can be associated with thymoma and with antibodies to the acetylcholine receptor (AChR), and is less commonly associated with antibodies to muscle-specific tyrosine kinase (MuSK). Treatment of AChR antibody-positive myasthenia gravis with the cholinesterase inhibitor, pyridostigmine, has known cardiac conduction side effects. Some reports indicate these cardiac effects, including bradyarrhythmias, occur more often with MuSK-ab positive MG. This report is of a 62-year-old man with recent onset muscle-specific tyrosine kinase (MuSK)-negative thymomatous myasthenia gravis presenting with bradycardia due to pyridostigmine-associated atrioventricular (AV) block.</p><p><strong>Case report: </strong>A 62-year-old man presented with fluctuating muscle weakness, unilateral ptosis, mild dyspnea, and mild dysphagia. Laboratory testing was positive for acetylcholine receptor antibodies (AChR-ab), but negative for MuSK antibodies. Due to his symptoms, treatment with intravenous immunoglobulin (IVIg) and pyridostigmine was initiated. Mediastinal computed tomography scan (CT scan) revealed a thymoma. During thymectomy surgery, the patient experienced intraoperative asystole. After he was stabilized, episodes of high-degree atrioventricular (AV) block were seen on postoperative ambulatory rhythm monitoring. Therefore, a permanent pacemaker (PPM) was implanted before repeat thymectomy, which was performed without complications Histopathological examination of the thymic tissue demonstrated a type B1 thymoma.</p><p><strong>Conclusion: </strong>This report has highlighted the importance of accurate diagnosis of MG and its autoimmune subtypes, and if treatment is required with pyridostigmine, the importance of follow-up and electrocardiographic monitoring to ensure the rapid diagnosis and management of cardiac conduction abnormalities, even if they are MuSK antibody-negative.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"225"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum CA125: a prognostic biomarker for mortality in chronic heart failure.","authors":"Ruzeguli Tuersun, Aihaidan Abudouwayiti, Yan Xiao Li, Ying Pan, Salamaiti Aimaier, Zhi-Ying Wen, Wei-Tong Gao, Li-Juan Ma, Ailiman Mahemuti, Ying-Ying Zheng","doi":"10.1186/s12872-025-04685-w","DOIUrl":"10.1186/s12872-025-04685-w","url":null,"abstract":"<p><strong>Objective: </strong>To examine the relationship between serum Carbohydrate Antigen 125 (CA125) levels and long-term mortality in Chronic Heart Failure (CHF) patients and to assess its predictive value as a biomarker.</p><p><strong>Methods: </strong>This was a retrospective cohort study. We reviewed the medical records of 4,442 consecutive patients admitted to the First Affiliated Hospital of Xinjiang Medical University with a diagnosis of CHF since July 2012. After applying inclusion and exclusion criteria, 1,413 patients with available CA125 level measurements were included. The patients were categorized into three groups based on ejection fraction: HFrEF, HFmrEF, and HFpEF. Demographic details, comorbidities, and laboratory parameters were collected. CA125 levels were measured using an automated chemiluminescent immunoassay. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression.</p><p><strong>Results: </strong>The median follow-up was 22.75 months. Elevated CA125 levels were significantly associated with increased all-cause mortality (ACM) across all CHF subtypes (HR = 2.05, 95% CI: 1.60-2.64, P < 0.001), especially in the HFpEF group (HR = 2.32, 95% CI: 1.59-3.40, P < 0.001). The area under the ROC curve for CA125 was 0.655, indicating moderate predictive accuracy. Multivariate analysis revealed that patients with CA125 levels ≥ 20.8 U/mL had a significantly higher risk of ACM (HR = 2.05). Adjustments for confounding factors did not alter these findings.</p><p><strong>Conclusion: </strong>Our findings suggest that serum CA125 levels may serve as a potential prognostic biomarker for mortality in CHF patients, particularly in the HFpEF subgroup. However, further research is needed to confirm these findings and elucidate the underlying mechanisms.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"227"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcomes of acute myocardial infarction during the COVID-19 pandemic: a multicenter retrospective cohort study in Northern China.","authors":"Kang Li, Yannan Pan, Xiaojian Song, Bin Yang, Huifeng Wang, Fan Yang, Quanbao Liu, Xinhong Lin, Shuzhen Zhao, Yuqi Yuan, Ze Zhang, Bin Zhang, Fangfang Fan, Dengfeng Ma","doi":"10.1186/s12872-025-04686-9","DOIUrl":"10.1186/s12872-025-04686-9","url":null,"abstract":"<p><strong>Background: </strong>The impacts of COVID-19 on acute myocardial infarction (AMI) care were heterogeneous. The study aims to analyze the clinical characteristics and outcomes of AMI patients in China during different stages of the COVID-19 pandemic.</p><p><strong>Methods: </strong>This is a multicenter retrospective cohort study in Shanxi Province of northern China. Patients diagnosed with AMI during the zero-case, lockdown, and outbreak periods were included. Characteristics and outcomes were analyzed according to time periods and COVID-19 infection. The primary outcome was in-hospital mortality. Additional outcomes included reperfusion times, coronary angiographic measures, procedure or AMI-associated complications, arrhythmia, other adverse events, and left ventricular systolic dysfunction (LVSD).</p><p><strong>Results: </strong>The study included 1021 AMI patients, with 393, 250, and 378 from the zero-case, lockdown, and outbreak periods. No differences in in-hospital mortality or other adverse events were found by time periods. By infection status, 264 patients were COVID-positive, and 706 were COVID-negative. The COVID-positive ST-elevation myocardial infarction population had longer symptom-to-first medical contact (3.07 vs. 2.31, p = 0.026), pre-hospital time (4.58 vs. 3.67, p = 0.032), door-to-balloon (1.20 vs. 1.08, p = 0.046), and total ischemic time (5.80 vs. 4.70, p = 0.011). No differences in other in-hospital outcomes were found, except that multivariate logistic regression analysis demonstrated COVID-19 infection was correlated with increased risks of LVSD (OR 1.73, 95% CI 1.11-2.69, p = 0.015).</p><p><strong>Conclusions: </strong>In-hospital mortality did not differ by time period or COVID-19 infection status. The COVID-positive AMI patients had longer reperfusion times and higher risks of LVSD. AMI treatments were impacted during the pandemic, and measures are warranted to minimize the reperfusion time.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"226"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic susceptibility to essential hypertension in the Chinese han population: a study on GAB1, GAB2, and GAB3 gene polymorphisms.","authors":"Jiajie Xiong, Lijun Zhu, Wanjun Zhang, Yurui Zhou, Yue Yu, Miao Xu, Pu Dong, Zhengmei Fang, WeiWei Chang, Yan Chen, Yingshui Yao, Yuelong Jin","doi":"10.1186/s12872-025-04669-w","DOIUrl":"10.1186/s12872-025-04669-w","url":null,"abstract":"<p><strong>Background: </strong>This study aims to examine the association between single nucleotide gene polymorphisms (SNPs) of GAB1, GAB2, and GAB3 and the genetic susceptibility to essential hypertension in the Chinese Han population. The findings of this research will contribute to understanding the underlying causes of hypertension.</p><p><strong>Methods: </strong>A community-based sampling survey was conducted in two towns in the south of Jiangsu Province to investigate the correlation between gene polymorphisms and essential hypertension. The study included a total of 2119 cases of hypertension and 2317 healthy controls, with an average follow-up period of 10.75 years. The genotypes of seven tagging SNPs (GAB1 rs300893 and rs11936966, GAB2 rs7107174, rs2450135, and rs3740677, GAB3 rs3813455 and rs5987015) were analyzed.</p><p><strong>Results: </strong>Regression analysis showed that after multifactor correction, only GAB1 rs300893 dominant model was statistically associated with the risk of hypertension among 7 SNPs locis before Bonferroni correction. Subgroup analysis showed that there were associations between specific SNPS and the risk of hypertension in different subgroups, but after Bonferroni correction, these associations were no longer statistically significant. In the follow-up study, Cox proportional hazard regression analysis showed that there was no significant association between the seven SNPs locis and the risk of hypertension. However, subgroup analyses suggest that some gene variants are associated with a reduced or increased risk of hypertension in specific populations. After Bonferroni correction, the addition model of GAB2 rs7107174 was still statistically significant in the specific stratified analysis. Plasma GAB1, GAB2, and GAB3 mRNA expression showed no significant difference between the hypertensive group and the control group.</p><p><strong>Conclusion: </strong>These findings provide additional support for the genetic role of GAB1, GAB2 and GAB3 in hypertension and blood pressure regulation.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"223"},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise combined with different dietary interventions on cardiovascular health a systematic review and network meta-analysis.","authors":"Yang Hei, Yongchao Xie","doi":"10.1186/s12872-025-04666-z","DOIUrl":"10.1186/s12872-025-04666-z","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have shown that exercise and dietary interventions positively impact CVD outcomes; however, there is substantial variability in the efficacy of different interventions. The absence of direct comparisons between multiple interventions complicates the determination of their relative effects. This study aims to synthesize the literature on the impacts of exercise, dietary, and combined interventions on cardiovascular health indicators, and to perform a network meta-analysis to rank the efficacy of these approaches, providing a theoretical foundation for selecting optimal intervention strategies.</p><p><strong>Methods: </strong>We systematically reviewed the literature from database inception through September 2024, searching PubMed, Web of Science, Embase, and the Cochrane Library. Data were aggregated and analyzed using network meta-analysis, with intervention efficacy ranked according to Surface Under the Cumulative Ranking (SUCRA) curves.</p><p><strong>Results: </strong>The efficacy of these interventions was ranked as follows: 1). Triglycerides (TG) Reduction: CR + EX > CR > 5/2F + EX > TRF + EX > KD > 5/2F > KD + EX > EX > CON > TRF. 2). Total Cholesterol (TC) Reduction: CR + EX > CR > 5/2F + EX > 5/2F > TRF + EX > EX > CON > KD > TRF > KD + EX. 3). High-Density Lipoprotein (HDL) Increase: 5/2F > KD > KD + EX > TRF + EX > CON > EX > TRF > 5/2F + EX > CR + EX > CR. 4). Low-Density Lipoprotein (LDL) Reduction: CR + EX > CR > TRF + EX > KD + EX > EX > KD > 5/2F > CON > 5/2F + EX > TRF. 5). Systolic Blood Pressure (SBP) Reduction: 5/2F > CR + EX > CR > EX > TRF > TRF + EX > CON > 5/2F + EX. 6). Diastolic Blood Pressure (DBP) Reduction: CR > CR + EX > TRF > 5/2F > TRF + EX > EX > CON > 5/2F + EX.</p><p><strong>Conclusion: </strong>CR and CR + EX demonstrated the most positive effects on cardiovascular health indicators. In contrast, 5/2F + EX ranked relatively low in effectiveness, with its impact on several indicators being even lower than that of CON.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"222"},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of an integrated prognostic model for all-cause mortality in heart failure: a comprehensive analysis combining clinical, electrocardiographic, and echocardiographic parameters.","authors":"Yahui Li, Jiayu Xu, Xuhui Liu, Xujie Wang, Chunxia Zhao, Kunlun He","doi":"10.1186/s12872-025-04642-7","DOIUrl":"10.1186/s12872-025-04642-7","url":null,"abstract":"<p><strong>Background: </strong>Accurate risk prediction in heart failure remains challenging due to its complex pathophysiology. We aimed to develop and validate a comprehensive prognostic model integrating demographic, electrocardiographic, echocardiographic, and biochemical parameters.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 445 heart failure patients. The cohort was randomly divided into training (n = 312) and validation (n = 133) sets. Feature selection was performed using LASSO regression followed by backward stepwise Cox regression. A nomogram was constructed based on independent predictors. Model performance was assessed through discrimination, calibration, and decision curve analyses. Random survival forest analysis was conducted to validate variable importance.</p><p><strong>Results: </strong>During a median follow-up of 4.14 years, 142 deaths (31.91%) occurred. Our model development followed a systematic approach: initial feature selection using LASSO regression identified 15 potential predictors, which were further refined to nine independent predictors through backward stepwise Cox regression. The final predictors included age, NYHA class, left ventricular systolic dysfunction, atrial septal defect, aortic valve annulus calcification, tricuspid regurgitation severity, QRS duration, T wave offset, and NT-proBNP. The integrated model demonstrated good discrimination for 2-, 3-, and 5-year mortality prediction in both training (AUCs: 0.726, 0.755, 0.809) and validation cohorts (AUCs: 0.686, 0.678, 0.706). Calibration plots and decision curve analyses confirmed the model's reliability and clinical utility across different time horizons. A nomogram was constructed for individualized risk prediction. Kaplan-Meier analyses of individual predictors revealed significant stratification of survival outcomes, while restricted cubic spline analyses demonstrated non-linear relationships between continuous variables and mortality risk. Random survival forest analysis identified the top five predictors (age, NT-proBNP, QRS duration, tricuspid regurgitation severity, NYHA), which were compared with our nine-variable model, confirming the superior performance of the integrated model across all time points.</p><p><strong>Conclusions: </strong>Our integrated prognostic model showed robust performance in predicting all-cause mortality in heart failure patients. The model's ability to provide individualized risk estimates through a nomogram may facilitate clinical decision-making and patient stratification.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"221"},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}